Are Home Births a Good Idea?
1. Having babies at home is certainly nothing new, but most births are done in a hospital setting today. Why is that?
Because hospitals can handle emergencies when a problem arises. They have medical equipment, they can perform surgery, and they have medications for pain relief, like epidurals. Also, hospital staff are available to wait on you, a luxury not always available at home.
2. I understand that homebirths are making a comeback, so to speak. Why is that?
Some couples want to have a natural birth without interventions in their home setting, with just the privacy of the family. The husbands can get more involved this way. There is less risk of infections for mom and baby, and the cost is much less.
3. Have there been any studies to verify the safety of homebirths?
Yes, the Mehl Study and the JAMA Study are perhaps the best known. Both basically concluded that low-risk home births are as safe or safer than hospital births.
4. What are some of the interventions that might routinely be performed in a hospital that would not be done in a homebirth?
In the hospital they have what they call Standard Operating Procedures (S.O.P.), which they must go by. As soon as the patient has been registered, the staff will obtain her OB history and do some additional blood work. Most women get IV's unless they refuse. Enemas are generally routine, although some doctors aren't doing that . They get hooked up to fetal monitors for monitoring contractions and FHT's. Labor is augmented by the use of Pitocin. Epidurals are freely given for pain, although the patient may choose to request a natural birth. Depending on the doctor, forcep deliveries or vacuum extractors may be used. Most doctors routinely give episiotomies (to create a bigger opening for delivery), and c-sections are becoming more common-place.
5. What should a couple look for in a midwife, and how can they know that the person is competent?
You should probably ask how many years of experience she has. Does she carry emergency and medical equipment (diagnostic instruments) like B.P. cuffs, stethoscopes, and chemstrips to the birth? Does she carry oxygen, an Ambu bag to administer a certain amount of oxygen by positive pressure to a severely depressed baby (this is very rarely needed at home)? Does she carry devices to listen to FHT's? How does she handle hemorrhages? Does she work with an assistant and is she trained as well in neonatal emergencies? Has she ever lost a baby or mother? Is she accessable (on call) all the time? Does she have a Doctor back-up that works with her? Does she do prenatals, labor and delivery, postpartum care?
6. Can you summarize the steps for a safe homebirth?
For a Safe Homebirth
Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee whithersoever thou goest. - Joshua 1:9